Misdiagnosis of Bipolar Affective Disorder as Personality Disorder

1993 ◽  
Vol 38 (9) ◽  
pp. 587-589 ◽  
Author(s):  
Stephen P. Tyrer ◽  
Andrew D. Brittlebank
Keyword(s):  
Personality Disorder ◽  
Affective Disorder ◽  
Interpersonal Relationships ◽  
Bipolar Affective Disorder ◽  
Behavioural Disturbance ◽  
The Past ◽  
Affective Symptoms ◽  
Personality Disturbance

Patients with longstanding recurrent behavioural disturbance, unstable interpersonal relationships and periodic affective symptoms are often diagnosed as having a cluster B personality disturbance using DSM-III-R criteria. Two women are described who were diagnosed as having a personality disorder on several admissions to hospital, but in whom closer inquiry revealed evidence of bipolar affective disorder. Since treatment with lithium and adjunctive mood-stabilizing drugs neither patient has required further admissions to hospital within the past five years.

Verapamil in Bipolar Illness

1986 ◽  
Vol 31 (5) ◽  
pp. 442-444 ◽  
Author(s):  
Leigh Solomon ◽  
Peter Williamson
Keyword(s):  
Calcium Channel ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Blocking Agent ◽  
Bipolar Illness ◽  
The Past ◽  
First Case ◽  
Treatment Of Depression ◽  
Channel Blocking ◽  
Successful Control

The authors report two cases of Bipolar Affective Disorder which were responsive to Lithium therapy in the past, but could no longer be treated with Lithium due to hyperparathyroidism in the first case and noncompliance in the second. In both cases, successful control of hypomania was achieved with Verapamil, but treatment of depression required the addition of Trazodone. The rationale for employing a calcium channel blocking agent, such as Verapamil, in bipolar illness is reviewed.

Differentiating Between Bipolar Affective Disorder (Bd) and Borderline Personality Disorder (BPD) – a Clinical Case

2016 ◽  
Vol 33 (S1) ◽  
pp. S504-S504
Author(s):  
A. Ballesteros ◽  
A. Petcu ◽  
B. Cortés ◽  
L. Montes ◽  
F. Inchausti ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Affective Disorder ◽  
Dialectical Behavior Therapy ◽  
Clinical Case ◽  
Bipolar Affective Disorder ◽  
Borderline Personality ◽  
Clinical Population ◽  
Clinical Approach ◽  
Novelty Seeking

IntroductionRecent studies suggest that Borderline Personality Disorder (BPD) could be regarded as an affective disorder within the Bipolar Affective Disorder (BP) spectrum. This is supported by evidence suggesting a clinical/neurobiological overlap between these two disorders. The Temperament and Character Inventory Revised (TCI-R) may help differentiate between the two disorders and orientate the clinical approach, considering the evidence of the medium-term temporal stability of TCI-R in a clinical population.ObjectiveWe present a clinical case diagnosed with BD which underwent testing using TCI-R. TCI-R orientated towards a secondary diagnosis of BPD and the case further received a course of Dialectical Behavior Therapy (DBT) which led to clinical improvement. We therefore study the usefulness of TCI-R in this clinical setting.AimsTo study whether TCI-R may help differentiate between BD and BPD in mood stabilized patients.MethodOur patient is a 52-year-old married male diagnosed with BD. Considering his clinical features of impulsivity/instability of behaviors and pathological interpersonal relationships, patient was started on individual DBT (fortnightly, 4 months). Psychotropic treatment (paroxetine 30 mg/day, lithium 1000 mg/day, aripiprazole 15 mg/day) was not modified.ResultsTCI-R scores: harm avoidance (100%), novelty seeking (53%), reward dependence (20%), persistence (18%), self-directedness (1%), cooperativeness (2%) and self-transcendence (48%). After 4 months of therapy, the patient improved in distress tolerance, acceptance, behavioral activation and assertiveness.ConclusionsTCI-R is an inventory for personality traits in which character scores differ markedly between PD and non-PD patients. It is a useful tool in BPD patients orientating the clinician in the differential diagnosis and the treatment approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The unbearable dispersal of being: Narrativity and personal identity in borderline personality disorder

2020 ◽  
Author(s):  
Philipp Schmidt ◽  
Thomas Fuchs
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Interpersonal Relationships ◽  
Narrative Identity ◽  
Borderline Personality ◽  
Life Goals ◽  
The Past ◽  
Narrative Structures ◽  
Sense Of Identity

AbstractBorderline personality disorder (BPD) is characterized by severe disturbances in a subject’s sense of identity. Persons with BPD suffer from recurrent feelings of emptiness, a lack of self-feeling, and painful incoherence, especially regarding their own desires, how they see and feel about others, their life goals, or the roles to which they commit themselves. Over the past decade or so, clinical psychologists, psychotherapists, and psychiatrists have turned to philosophical conceptions of selfhood to better understand the borderline-specific ruptures in the sense of identity, which are frequently associated with severe affective instability and turbulence in interpersonal relationships. Fuchs (2007) has suggested that these disturbances in self-experience can best be described and explained by using notions—widely discussed in philosophy and psychology—of narrativity and narrative identity. On such a narrative view, key features of BPD present significant modifications of proto-narrative structures and inhibit the development of a narrative identity, resulting in a disturbed sense of identity. Although the role of narrativity in BPD has been acknowledged by many researchers, some have voiced dissatisfaction with what they take to be limitations of a narrativistic understanding of the disorders of identity characterizing BPD, and have proposed alternative, allegedly non-narrativistic, accounts. In this paper, we critically examine an example of the latter, viz. Gold and Kyratsous’ (2017) account of the person as an intrapersonal team reasoner. We defend a narrativistic understanding of BPD identity disorder against their objections. To this end, we propose a broader, and more finely-differentiated, concept of narrativity. On this account, four aspects of narrativity are distinguished, the disordering of which can affect those with BPD. As it turns out, our account implies that even Gold and Kyratsous—in order to ground their approach—must either make use of these aspects or propose an as-yet unarticulated alternative. This casts doubt upon whether their approach is non-narrativistic after all.

scholarly journals Difficulties associated with the diagnosis of bipolar affective disorder in a 16-year-old boy treated in the past for ADHD and ODD – case study

2020 ◽  
Vol 21 (1) ◽  
pp. 29-38
Author(s):  
Izabela Chojnowska-Ćwiąkała ◽  
Justyna Świerczyńska ◽  
Małgorzata Weryszko ◽  
Monika Szpringer
Keyword(s):  
Affective Disorder ◽  
Personality Development ◽  
Bipolar Affective Disorder ◽  
Diagnostic Process ◽  
List Type ◽  
The Past ◽  
Psychotherapeutic Interventions ◽  
Oppositional Defiant ◽  
Pediatric Psychiatry ◽  
High Dynamics

AbstractAim: The aim of this article is to discuss the difficulties and complexities of the bipolar affective disorder (BPAD) diagnostic process in an adolescent. The case of suspected occurrence of bipolar affective disorder in an adolescent who was diagnosed with attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in childhood was presented.Case report: A 16-year-old boy was treated in the past for ADHD and ODD. The reason for the current admission to the pediatric psychiatry ward was the behavioral change that disturbed the caregivers: he has become more restless, irritable, explosive. A few nights prior to hospitalization, he was very agitated, chaotic, physically and verbally aggressive.At admission he was disorganized, tense, in strong hand manipulation anxiety. He displayed alternating attention and loquacity. His statements were chaotic, his thinking accelerated. He displayed grandiose delusions. He was uncritical.After the treatment, mood, psychomotor drive and circadian rhythms stabilisation were achieved. Discharged from the ward with the recommendation of further outpatient treatment and continuation of psychotherapeutic interactions.Conclusions:1.The diagnosis of bipolar affective disorder in adolescents is a complex and difficult process. The expression of symptoms of this disorder during adolescence is different than in adults.2.Differential diagnosis of bipolar affective disorder for a 16-year-old boy should also consider both past ADHD and ODD and their possible sequelae should be taken into account, as well as the risk of abnormal personality development.3.Due to the high dynamics of changes associated with the adolescence period, further pharmacological treatment of bipolar affective disorder should be combined with psychotherapeutic interventions.

scholarly journals Considerations on assisted resilience and individualized therapy in bipolar affective disorder, with a clinical case exemplification

2015 ◽  
Vol 88 (4) ◽  
pp. 462-467 ◽  
Author(s):  
Alexandra Bolos
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Clinical Case ◽  
Bipolar Affective Disorder ◽  
Indirect Costs ◽  
Economic Consequences ◽  
Case Presentation ◽  
Affective Symptoms ◽  
Psychosocial Consequences

Morbidity, mortality and economic consequences of bipolar affective disorder are very important to be evaluated because many of the costs entailed by this psychiatric disorder come from indirect costs due to inadequate diagnosis and treatment and from the characteristics of the affective symptoms itself. Psychotherapy focuses on diagnosis and the newest pharmacotherapy determines a decreasing of the morbidity of the disorder and also of its social and economic burden . However, more studies are necessary, with more heterogeneous patients, to find more predictors regarding the psychosocial consequences and to find more information about the prognosis of the bipolar disorder.In this context, in this paper we discuss the role of assisted resilience and the individualization of the therapy of bipolar affective disorder, especially that the resilience must be seen as a continuum and can be used anytime and in any situation, according to the theory of Geanellos. This idea is reflected in a case presentation of a patient with the diagnosis of bipolar disorder.

Premenstrual Symptoms as an Indicator of Bipolar Affective Disorder

1971 ◽  
Vol 119 (552) ◽  
pp. 527-528 ◽  
Author(s):  
James N. McClure ◽  
Theodore Reich ◽  
Richard D. Wetzel
Keyword(s):  
Depressive Disorder ◽  
Psychiatric Disorders ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Premenstrual Symptom ◽  
Premenstrual Symptoms ◽  
Affective Symptoms ◽  
Symptom Exacerbation

The premenstrual occurrence or exacerbation of affective symptoms has been noted (Dalton, 1964). This symptom exacerbation may be sufficient to require hospitalization (Dalton, 1959; Janowsky et al., 1966). Data presented by Coppen (1965) indicate that women with affective disorder are more likely to report the premenstrual symptom of depression than women with other psychiatric disorders. These findings suggest that there may be some relationship between depressive disorder and premenstrual symptoms. However, we are aware of no previous report that would suggest any relationship between premenstrual symptoms and bipolar affective disorder.

The epidemiology of bipolar affective disorder; a review of the literature and introduction to work in progress

2000 ◽  
Vol 12 (3) ◽  
pp. 99-103 ◽  
Author(s):  
T. Lloyd ◽  
P.B. Jones
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Epidemiological Study ◽  
Affective Disorders ◽  
Bipolar Affective Disorder ◽  
Review Of The Literature ◽  
Epidemiological Research ◽  
Psychological Treatments ◽  
Bipolar Illness ◽  
The Past

ABSTRACTThe past 20 years have seen much research into affective disorders, reflecting advances in both pharmacological and psychological treatments. However, there has been little basic epidemiological research into bipolar illness. This is particularly apparent regarding its basic occurrence and possible epigenetic causes. This presentation will attempt to bring together and integrate the available evidence regarding the basic epidemiology of bipolar disorder, define areas where further research is needed, and outline a large epidemiological study including bipolar affective disorder that has been supported by the Stanley Foundation.

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